Thursday, May 20, 2010
sites for download "indowebster"
"indowebster"
indowebst
er.com is a site that provides a variety of content that we can download, including music, movies, ebooks, etc..
Like youtube.com, rapidshare.com, imageshack.us this site is three in one.
indowebst
er.com is a site that provides a variety of content that we can download, including music, movies, ebooks, etc..
founded by Juny usually called Acong Maimun or three years ago. Previously, he launched Indofile, but only a year old. Then, Acong changing concept of fusion indofile be Indowebster Rapidshare, ImageShack, and YouTube.
In Indowebster, not just download and upload files, but users can also upload pictures and videos on Indowebster. Looking ahead Acong are preparing a new strategy to expand Indowebster services, namely providing internet TV service.
how to download on this site:
1. select it and click Mozillah Explorer, after which it will appear the first page of the mozilla website.
2. The first step we open a website www.indowebster.com
will be a lot of menus that will display in the show by indowebster.com Such as register, login, Category, Playlists, Userpanel, IDWS, upload, directory, Advertisements.
Then we will choose one that is "CATEGORY"
So we must select an object that we want to download. Let's say, we will download the song. So we pick and click MP3/AUDIO including on site www.the-movieku.blogspot.com
But there are many options-such as the choice of manga, E-books, arts / wallpaper, documentary, film, movies trailers, picture, games, horror, ETC, funny, MP3/music Audio, sports, software, TV EPS / Drama.
After the vote we must determine the name of the band / song that we want to download.
1. write the name of the band / song at keword
2. Select and click search
Then the display will show the file icon and description. You just choose one song that you want.
3. Then right click on a file in the select. Then click Open Link in New Tab.
4. Then will come info file that you select. That there also have title, views, server ID, the forum tags, and description. After that click on Download from IDWS
5. After that will appear Opening a place for opening files of your choice
a. select it and click Open with
b. select it and click Ok
6. Once this box will appear on the screen where you will store the files you've selected:
a. will enter the name of the file appears to save to ...
b. click the file name in file name
c. select it and click Save
After that dialog box will appear "DOWNLOAD", which means your file is a file transfer process.
And thank you so hopefully this info can help you download in the indowebster.com
GROUP STORY unique, strange, and interesting!
FOOD world's most expensive
Where you can obtain the world's most expensive food? In the U.S., French, Dutch, or English? Not. The answer is in Sri Lanka, one of the poorest country in the world. The Fortress resort in the country claiming to provide the world's most expensive food. The price reached 14,000 U.S. dollars or approximately USD 132 million.
You want to know what kind of food?
Foods that are sugar-containing fruit decorated sugar fisherman statue made of chocolate and a giant gemstone. Public Relations Manager of The Fortress Shalini Perera, said the food called The Fortress Stilt Fisherman Indulgences was created to provide new experiences to its visitors the resort.
Perera added that the expensive menu must be ordered visitors in particular. He confessed, so far it has received many calls asking for the food, including a phone call from Japan. However, until now no one wants to spend money to try the expensive menu.
Record in the world of sex
There are few records in the world of sex that is said not all proven, but the world really feels incomplete without the weird stuff, funny or even stupid. So, we enjoy Just a few facts 'rare' the following:
Males With Most Descendants
Moulay Ismail Ibn Sharif is a man of Moroccan origin who lived in the 17th century, descendants as many as 1042 people have to do with the results of about 500 wives and concubines.
Women Most Often Childbirth
A farmer's wife in Shuya, East Moscow gave birth to as many as 27 times a year between 1725 until 1765. She gave birth to 16 pairs of twins, seven times gave birth to twins three and four times gave birth to twins four.
Mr. Largest P
According to the data recorded, there was a man who has Mr. P throughout the 34 cm and 16 cm wide lho! This man is measured by Dr intimate parts. Robert L. Dickenson in the 20th century.
Mr. Smallest P
There is the biggest, definitely there is also the smallest. Mr. P smallest ever found is only equal to 1 cm. That said, there are some men who have this condition, called 'micropenis', where Mr. P is located inside the body.
Biggest Sex party
Set of people in Japan was awarded the world record in sex because sex party held the largest, with 250 couples participating in an event such extreme enough.
Youngest Parents
Shaun Steard aged 12 years old when his father received an award as the youngest, yet many people believe there are fathers aged younger than him that are not listed. And as the world's youngest mother was Lina Medina, who gave birth to a child at the age of 5 years!.
Most Remote Ejaculation
Ejaculate the furthest distance man, who never recorded was 6 feet and as far as this record is held by men from the United States, Horst Schultz. Meanwhile, for women as far as three meters, but her identity was published.
Where you can obtain the world's most expensive food? In the U.S., French, Dutch, or English? Not. The answer is in Sri Lanka, one of the poorest country in the world. The Fortress resort in the country claiming to provide the world's most expensive food. The price reached 14,000 U.S. dollars or approximately USD 132 million.
You want to know what kind of food?
Foods that are sugar-containing fruit decorated sugar fisherman statue made of chocolate and a giant gemstone. Public Relations Manager of The Fortress Shalini Perera, said the food called The Fortress Stilt Fisherman Indulgences was created to provide new experiences to its visitors the resort.
Perera added that the expensive menu must be ordered visitors in particular. He confessed, so far it has received many calls asking for the food, including a phone call from Japan. However, until now no one wants to spend money to try the expensive menu.
Record in the world of sex
There are few records in the world of sex that is said not all proven, but the world really feels incomplete without the weird stuff, funny or even stupid. So, we enjoy Just a few facts 'rare' the following:
Males With Most Descendants
Moulay Ismail Ibn Sharif is a man of Moroccan origin who lived in the 17th century, descendants as many as 1042 people have to do with the results of about 500 wives and concubines.
Women Most Often Childbirth
A farmer's wife in Shuya, East Moscow gave birth to as many as 27 times a year between 1725 until 1765. She gave birth to 16 pairs of twins, seven times gave birth to twins three and four times gave birth to twins four.
Mr. Largest P
According to the data recorded, there was a man who has Mr. P throughout the 34 cm and 16 cm wide lho! This man is measured by Dr intimate parts. Robert L. Dickenson in the 20th century.
Mr. Smallest P
There is the biggest, definitely there is also the smallest. Mr. P smallest ever found is only equal to 1 cm. That said, there are some men who have this condition, called 'micropenis', where Mr. P is located inside the body.
Biggest Sex party
Set of people in Japan was awarded the world record in sex because sex party held the largest, with 250 couples participating in an event such extreme enough.
Youngest Parents
Shaun Steard aged 12 years old when his father received an award as the youngest, yet many people believe there are fathers aged younger than him that are not listed. And as the world's youngest mother was Lina Medina, who gave birth to a child at the age of 5 years!.
Most Remote Ejaculation
Ejaculate the furthest distance man, who never recorded was 6 feet and as far as this record is held by men from the United States, Horst Schultz. Meanwhile, for women as far as three meters, but her identity was published.
My poems
end of love story
This poignant sense of scraping heart, I lay in a quiet ...
no one knows and understands me, not him nor ye ...
Handshake as a sign of greeting your last ...
who accompanied my steps began to shake in the indecisive ...
who increasingly feel the hurt inside, when I know you ...
See morebersanding with your new lover ...
not again you ask me about my taste, do not you ask me again about my injury ...
dustai feeling for so long, you tie me with your sweet promises. let me take my chips injury in cyberspace ...
beautiful in the imagination but it ended sadly for me.
READ MORE - My poems
This poignant sense of scraping heart, I lay in a quiet ...
no one knows and understands me, not him nor ye ...
Handshake as a sign of greeting your last ...
who accompanied my steps began to shake in the indecisive ...
who increasingly feel the hurt inside, when I know you ...
See morebersanding with your new lover ...
not again you ask me about my taste, do not you ask me again about my injury ...
dustai feeling for so long, you tie me with your sweet promises. let me take my chips injury in cyberspace ...
beautiful in the imagination but it ended sadly for me.
how to save dating tips
1. priority list
If you do not, it should be noted that the courtship was always No. 2. For example you have credit card bills that have not been paid while you take the pledge he had a romantic dinner in a luxury hotel. Instead, prioritize your salary to pay old debts. Then, change your eating dinner so simple luxury.
2. not debt
Amounted to anything you wanted to make a boyfriend even more in love with you, do not ever get all the debt. Nature of you who are too extravagant / wasteful, it makes you so soft targets girls / boys matre. Rather than a matre owe for boyfriend, he broke ye better, find a clever boyfriend of financial control, and efficient. Not true?
3. Consideration of second item
now not all all-new! You want to go to birthday party boyfriend. TPI not enough pocket money to buy new watches. Try it, you go to the flea market, find an hour antic whose condition is still good, but the price is affordable. Let me cheap, but quality. Right?
4. A plate of both
It seems very hypocritical, how knyang eat a plate of both. But do not be skeptical first, dong. Many shops / restaurants sediain jumbo, if a little jelly, and the portion of a lot cheaper too. Make small shop / restaurant is a place both of you favorite date. If both embarrassed sepring, search packs aj-efficient ...
5. Important not to eat dinner dating
Courtship should not be initiated or at end with mkan-eating alone, right? Let frugal, pacarn quite filled with stories to share, vent, joke, etc.. If I can, going out in the house of one party boy or girl aj. Let me not long. If you decide dating outside, before you go, eat in their own homes first. So spending money on the tube can create the future.
6. joint venture
The term joint venture is still tabuh buatt some girl or boy. Since it was considered proper for a guy who will pay for all needs of the family head girl. Unfortunately now reversed with the poor as the desire is not a problem if you have to ptungan. Skalian test the extent of togetherness and love you guys.
7. Put yourself in nature
Instead of rah who do not clearly better or closer to the cool nature back to nature. For example go to the beach, rural or mountain. In assure more efficient!
8. Many, many prayers
If you and she diligently worship and approach God would you look at property as a complement to love open the main menus.
all according to how common maniac?? comments awaited him yes ... wkwkwkwkwkwk
If you do not, it should be noted that the courtship was always No. 2. For example you have credit card bills that have not been paid while you take the pledge he had a romantic dinner in a luxury hotel. Instead, prioritize your salary to pay old debts. Then, change your eating dinner so simple luxury.
2. not debt
Amounted to anything you wanted to make a boyfriend even more in love with you, do not ever get all the debt. Nature of you who are too extravagant / wasteful, it makes you so soft targets girls / boys matre. Rather than a matre owe for boyfriend, he broke ye better, find a clever boyfriend of financial control, and efficient. Not true?
3. Consideration of second item
now not all all-new! You want to go to birthday party boyfriend. TPI not enough pocket money to buy new watches. Try it, you go to the flea market, find an hour antic whose condition is still good, but the price is affordable. Let me cheap, but quality. Right?
4. A plate of both
It seems very hypocritical, how knyang eat a plate of both. But do not be skeptical first, dong. Many shops / restaurants sediain jumbo, if a little jelly, and the portion of a lot cheaper too. Make small shop / restaurant is a place both of you favorite date. If both embarrassed sepring, search packs aj-efficient ...
5. Important not to eat dinner dating
Courtship should not be initiated or at end with mkan-eating alone, right? Let frugal, pacarn quite filled with stories to share, vent, joke, etc.. If I can, going out in the house of one party boy or girl aj. Let me not long. If you decide dating outside, before you go, eat in their own homes first. So spending money on the tube can create the future.
6. joint venture
The term joint venture is still tabuh buatt some girl or boy. Since it was considered proper for a guy who will pay for all needs of the family head girl. Unfortunately now reversed with the poor as the desire is not a problem if you have to ptungan. Skalian test the extent of togetherness and love you guys.
7. Put yourself in nature
Instead of rah who do not clearly better or closer to the cool nature back to nature. For example go to the beach, rural or mountain. In assure more efficient!
8. Many, many prayers
If you and she diligently worship and approach God would you look at property as a complement to love open the main menus.
all according to how common maniac?? comments awaited him yes ... wkwkwkwkwkwk
tips to save money for smokers
I want to tell you,
dg I hope this story provides enlightenment convey verifiable common friends (these tips are not coercive).
fit it in the morning I saw a study on the FAP about how to economize and bersodakoh by cleric (forget his name).
He said:
REDUCE CIGARETTE learn.
according dg true story narrated by the owner who Steak AND SHAKE Waroeng who already has 40 branches throughout Indonesia and d has 700 employees.
He calculates how much money wastage employees to smoke in each month. and apparently the staff have to spend money on his salary amounted to 200 thousand rupiahs burn paper just to fill the leaf. after that the director invited the men to voluntarily reduce consumption ciggarete sincere. then the money saved. And here's how the results of her savings in almost a year?
21,000,000.00 rupiah!
Want to try? :)
let is a friend ... smoking allowed ... but should be reduced ... tables of the money it is pity. If you do not want to die first hell hell: p
READ MORE - tips to save money for smokers
dg I hope this story provides enlightenment convey verifiable common friends (these tips are not coercive).
fit it in the morning I saw a study on the FAP about how to economize and bersodakoh by cleric (forget his name).
He said:
REDUCE CIGARETTE learn.
according dg true story narrated by the owner who Steak AND SHAKE Waroeng who already has 40 branches throughout Indonesia and d has 700 employees.
He calculates how much money wastage employees to smoke in each month. and apparently the staff have to spend money on his salary amounted to 200 thousand rupiahs burn paper just to fill the leaf. after that the director invited the men to voluntarily reduce consumption ciggarete sincere. then the money saved. And here's how the results of her savings in almost a year?
21,000,000.00 rupiah!
Want to try? :)
let is a friend ... smoking allowed ... but should be reduced ... tables of the money it is pity. If you do not want to die first hell hell: p
how quickly the list of adsense
Those who want to register with google adsense is just now becoming more difficult to approve. It's me there are ways that you tried. hopefully this way you can be lucky: D
how:
1. Create an account at google.com.
2. If you have one of these accounts can be automatically used in all facility google. Now you create a free blog at blogger.com.
3. If you've selected a template, colors, add a sitemap and already enrolling with google.com. Soon the contents of the article you with the English language articles. Relax, I'm not going to tell you too meticulous. Simply create an article in the Indonesian language and translate it to english using google translate.
4. Create an article of at least 10-15 articles. Submit each article that you make to social bookmarking. Aja search on google.com definitely available lots. Why bother at all submit to social bookmarking. The reason is simple, it is to quickly bring in visitors.
Maybe that's just five ways. Now the most important are:
1. Set your blog or website into English. Way into the settings - format. By default should be in Indonesian language (Bener not ya) If it should you will see there is an additional tab on the right Layout reads "money".
2. List of Google AdSense ads through the application.
3. To guard - guard should not use standard templates and delete the old widget "About Me".
Important note:
1. Before doing all that sure that the site you are correct - correctly indexed in google.com. Remember! Google.com. So when you list your blog URL, you also have to list on Google.com is not Google.co.id. How to check the type: "SITE: URLBlogKamu". example: SITE: GOOGLE.COM (No need to use quotation marks). Do not forget to search on Google.com.
how:
1. Create an account at google.com.
2. If you have one of these accounts can be automatically used in all facility google. Now you create a free blog at blogger.com.
3. If you've selected a template, colors, add a sitemap and already enrolling with google.com. Soon the contents of the article you with the English language articles. Relax, I'm not going to tell you too meticulous. Simply create an article in the Indonesian language and translate it to english using google translate.
4. Create an article of at least 10-15 articles. Submit each article that you make to social bookmarking. Aja search on google.com definitely available lots. Why bother at all submit to social bookmarking. The reason is simple, it is to quickly bring in visitors.
Maybe that's just five ways. Now the most important are:
1. Set your blog or website into English. Way into the settings - format. By default should be in Indonesian language (Bener not ya) If it should you will see there is an additional tab on the right Layout reads "money".
2. List of Google AdSense ads through the application.
3. To guard - guard should not use standard templates and delete the old widget "About Me".
Important note:
1. Before doing all that sure that the site you are correct - correctly indexed in google.com. Remember! Google.com. So when you list your blog URL, you also have to list on Google.com is not Google.co.id. How to check the type: "SITE: URLBlogKamu". example: SITE: GOOGLE.COM (No need to use quotation marks). Do not forget to search on Google.com.
Miastenia Gravis
Miastenia gra
vis is an autoimmune disorder characterized by abnormal and progressive weakness of skeletal muscle that is used constantly and is accompanied by fatigue during recess beraktivitas.Bila patients, so there is no muscle power will soon recover. This disease occurs due to disruption or synaptic transmission at the neuromuscular junction.
Epidemiology
Miastenia gravis is a rare disease, and can occur at any age. This disease is usually more often seen at the age of 20-50 years. Women more often than men suffer from this disease. Ratio of women and men who suffer miastenia gravis is 6: 4. In women, this disease appears early in life, which is about 28 years, whereas in men, the disease often occurs at the age of 42 years.
ANATOMY, PHYSIOLOGICAL, and biochemical neuromuscular junction
a. Anatomy of the neuromuscular junction
Before an understanding of miastenia gravis, knowledge of anatomy and normal function of the neuromuscular junction is very important. Every normal nerve fibers branched several times and stimulated three to several hundred skeletal muscle fibers. nerve endings to create a connection called the neuromuscular junction or the neuromuscular junction. Part of motor nerve terminals eventually called the ball wide on the terminal, which lies in between the cracks found along nerve fibers. Presinaptik membrane (membrane of the nerve), post-synaptic membrane (membrane of the muscle), and the synapse is a gap to form part of the neuromuscular junction.
b. Neuromuscular Physiology and Bi
ochemistry
Synapse is the gap between the membrane and presinaptik post synaptic membrane. Ranged from 20-30 nanometers wide and filled by a basal lamina, which is a thin layer of reticular fibers as the foam that can be passed by the extracellular fluid by diffusion. Presinaptik terminals containing acetylcholine-containing vesicles in it (ACH). Acetylcholine is synthesized in the cytoplasm terminal, but quickly absorbed into the small number of synaptic vesicles, which are usually located at the terminal end plate motor (the motor end plate). When a nerve impulse arrives at the neuromuscular junction, approximately 125 bags of acetylcholine release from synaptic terminals into the crack. When the action potential spreads throughout the terminal, there will be diffusion of calcium ions into the interior of the terminal. Calcium ions then have the effect of acetylcholine vesicles is expected to attract. Some will be incorporated into the membrane vesicles and released into the nerve asetilkolinnya synaptic gap. Release of acetylcholine diffuses throughout the synapse and bind to the acetylcholine receptors (AChRs) in the post synaptic membrane. With a biochemist at the neuromuscular junction whole process takes place in six stages are considered, namely:
1. Acetyl choline synthesis occurs at the nerve terminal cytosolic enzyme choline acetyltransferase using catalyzed reaction follows: Acetyl-CoA + choline + CoA à Acetylcholine
2. Acetylcholine then inserted into a small vesicle-membrane bound particles called sinap and stored in vesicles.
3. The release of acetylcholine from synaptic vesicles to the gap represents the next stage. This occurs through eksositosis involving vesicle fusion with the membrane presinaptik. In the resting state quanta, single (about 10,000 transmitter molecules that may be appropriate to the content of synaptic vesicles) will be released spontaneously, resulting in a small miniature endplate potential. If the end of the depolarization caused by nerve experienced transmission of nerve impulses, the process will open the channels Ca2 + sensitive to voltage, which allows the entry of Ca2 + from the space into synaptic nerve terminals. This Ca2 + ions play an important role in asitilkolin eksositosis release (the contents of about 125 vesicles) into the cavity of the synapse.
4. Acetylcholine is released will spread rapidly in the synaptic gap to receptor within the folds of the links (junctional folds), are an important part containing the motor end plate acetylcholine receptor (AChR) with high density and very dense with nerve terminal. If the two molecules bound to the acetylcholine receptor, the receptor will change shape by opening the channels of the receptor that allows the flow of cations across the membrane. The entry of Na + ions will cause depolarization of muscle membrane, forming an end plate potential. This situation will then lead to muscle membrane depolarization and action potential occurred near transmitted along nerve fibers causing muscle contraction.
5. If the channel is closed, acetylcholine will rot and hydrolyzed by the enzyme acetylcholinesterase which catalyzes the following reaction: Acetylcholine + H ¬ ¬ à Acetate + 2o Kolin.Enzim important to have large quantities in the cavity of synaptic basal lamina
6. Recycling choline into nerve terminals via an active transport mechanism in which the protein can be reused for the synthesis of acetylcholine.
Each of acetylcholine receptors are large protein complexes with channels that will open soon after the compliance of acetylcholine. This complex consists of five protein subunits, yatiu 2 alpha protein, and one each protein, beta, delta and gamma. Acetylcholine compliance allows the sodium can move easily across the channel, so that will happen partial depolarization of the post-synaptic membranes. This event will cause a change in local potential at the muscle fiber membrane called excitatory postsynaptic potential (the potential end of the plate). When opening the door of sodium is sufficient, there will be action potentials in the muscle membrane which in turn causes muscle contraction.
Some properties of acetylcholine receptors at the neuromuscular junction are as follows:
• Represents nikotinik receptor (nicotine receptor agonists are)
• It is a membrane glycoprotein with a molecular weight of about 275 kDa.
• Contains five subunits, consist of?
• Only a subunit? acetylcholine binds with high affinity.
• Two acetylcholine molecules must bind to open ion channels, which allow the flow of either Na + or K +.
• Can the snake-binding Bungarotoksin? Subunits closely, and can be used to label as a receptor or ligand berafinitas to fix it.
• autoantibody to the receptor, including the cause of miastenia graphics.
Pathophysiology
Immunogenic mechanisms play a very important role in the pathophysiology miastenia gravis. Clinical observations that support this, including autoimmune disorders associated with the incidence of patients who suffer miastenia gravis, such as autoimmune thyroiditis, systemic lupus erythematosus, rheumatoid arthritis, and others.
Starting in 1960, has demonstrated how autoantibodi miastenia gravis patients in the serum directly to constituents in the muscle. This is what plays an important role in weakening the muscles of patients with miatenia gravis. No doubt, that nikotinik acetylcholine receptor antibody on the main causes of muscle weakness in patients with miastenia gravis. Autoantibodi against acetylcholine receptor (anti-AChRs) has been detected in the serum of 90% of patients suffering from acquired gravis gravis general.
Appropriate mechanisms of loss of tolerance to the acetylcholine receptor imunologic miastenia gravis patients are not fully understood. Miastenia gravis can be said as a "disease associated with B cells", in which antibodies are the product of B cells in fact against the acetylcholine receptor. The role of T cells in the pathogenesis miastenia gravis began increasingly prominent. Thymus is the central organ of the immune abnormalities associated with T cell hyperplasia of the thymus as the thymus or thymoma, usually appears earlier in patients with symptoms miastenik. In miastenia gravis patients, IgG antibodies consist of a variety of different subklas, where one antibody directly against the main immunogenic region on the alpha subunit. Alpha subunit is also the acetylcholine binding site. Association of acetylcholine receptor antibodies on acetylcholine receptor would lead to obstruction of neuromuscular transmission in several ways, including: cross-acetylcholine receptor anti-acetylcholine receptor antibodies and reducing the number of acetylcholine receptors at the neuromuscular junction by way of destroying the connection of the bonds at post synaptic membrane, thereby reducing the surface area that can be used for the insertion of newly synthesized acetylcholine receptors.
CLINICAL SYMPTOMS
Miastenia gravis characterized by fluctuating skeletal muscle weakness and this weakness will increase every time they move. Patients will feel very weak muscles in the day and this weakness will be reduced if the rest of the patient. Miastenia gravis clinical symptoms include:
a. Weakness in the muscles or ptosis ekstraokular
Ptosis, which is one symptom of okulomotorius nerve paralysis, the main complaint seing miastenia gravis patients. Although miastenia gravis on unclear palpebra Levator muscle paralysis, but sometimes the eye muscles are still moving normally. But in advanced stages of ocular muscle paralysis on both sides will complete ptosis miastenia gravis. bulbar muscle weakness are also common, followed by weakness in flexion and extension of the head. Patients with muscle weakness gets worse the longer it will. weakness will spread from the ocular muscles, facial muscles, neck muscles, the muscles of extremities. From time to time can also arise from the masseter muscle weakness so difficult for the patient's mouth shut. But they can also arise from the weakness of the muscles of the pharynx, tongue, Lissoclinum pallatum, and larynx so that the resulting difficulty swallowing and speaking. Paresis of Lissoclinum pallatum will cause nasal voice. Also if the patient drink water, water can get out of his nose.
CLASSIFICATION MIASTENIA Gravis
According to the Myasthenia Gravis Foundation of America (MGFA), berikut7 miastenia gravis can be classified as:
a. First class
The existence of the weakness of ocular muscles, weakness at the time of closing the eyes, and other muscles of normal strength.
b. Class II
There are more severe ocular muscle weakness, and mild muscle weakness in muscles other than ocular.
c. Class IIa
Affect axial muscles, limbs, or both. There are also mild weakness of oropharyngeal muscles.
d. Class IIb
Affecting oropharyngeal muscles, respiratory muscles or both. Weakness in leg muscles and axial muscles are lighter than grade IIA.
e. Class III
There are serious weaknesses in the ocular muscles. While other muscles in addition to moderate muscle weakness experienced eye.
f. Class IIIA
Affecting the leg muscles, axial muscles, or both, is very dominant. There was mild weakness of oropharyngeal muscles.
g. Class IIIB
Affect oropharyngeal muscles, respiratory muscles, or both, is very dominant. There is weakness of leg muscles, axial muscles, or both, in light level.
h. Class IV
Other than experience severe muscle weakness in the degree of ocular muscles, whereas the ocular muscle weakness experienced in various degrees.
i. Class IVA
With primarily affects the muscles or limbs and axial muscles. oropharyngeal muscle weakness is experienced in mild degrees.
j. Class IVb
Affecting the oropharyngeal muscles, respiratory muscles or both, the main thing. There is also a weakness in the muscles of limbs, axial muscles, or both with a mild degree. Patients using a feeding tube without intubation performed.
k. Class V
Terintubasi patients, with or without mechanical ventilation.
Usually symptoms closet gravis ptosis and strabismus miastenia will not be visible in the morning. At night or during hot weather, symptoms will appear more clearly. On examination, the muscle appeared somewhat decreased.
Miastenia gravis can also be grouped with a more simple way as below ini3:
a. Miastenia gravis with mild ptosis or diplopia.
b. Miastenia gravis by ptosis, diplopi, and weakness of the muscles for chewing, swallowing and speaking. tubuhpun members can participate Muscles become weak. Breathing is not affected.
c. Gravis Miastenia happens fast with muscle weakness okulobulbar. Breathing is not affected. Patients can die.
DIAGNOSIS MIASTENIA Gravis
a. Diagnosis Enforcement Miastenia Gravis
With a thorough physical examination should be performed to diagnose miastenia gravis. muscle weakness can occur in different degrees, typically in the proximal part of the body and symmetrical on both left and right leg. tendon reflexes are usually still within normal limits.
Miastenia gravis is usually always accompanied by weakness of facial muscles. Bilateral facial muscle weakness will cause the face like a mask with ptosis and horizontal smile.
bulbar muscle weakness are also common in patients with miastenia gravis. On physical examination, there was muscle weakness of the palate, which causes sufferers sounds like being in the nose (nasal twang to the voice) and regurgitation of food, especially the character of liquid into the patient's nose. In addition, miastenia gravis patients will have difficulty in chewing and swallowing food, so it can happen menyebabbkan fluid aspiration when drinking cough and choke. Weakness in the muscles of the jaw causes miastenia gravis patients difficult to close the mouth, chin so that the patient should be kept continuous with his hands. neck muscles are also experiencing weakness, so that an interruption occurs during flexion and extension of the neck.
Limb muscles from certain experiences more often than the weakness of the muscles of the body of another member, whereby the muscles of your upper body more frequently experience muscle weakness compared with the lower limb. Deltoid muscle function and extension at the wrist and fingers often experience weakness. Triceps muscles more commonly affected than the biceps. At the bottom of the foot, weakness often occur when doing hip flexion, and dorsiflexion of the toes as compared with the toes do plantarfleksi.
respiratory muscle weakness can result from acute respiratory failure, which is a state of emergency and quick action is required intubation. Intercostal and diaphragm muscle weakness can cause retention of carbon dioxide will cause hypoventilation. pharyngeal muscle weakness may cause airway collapse, strict controls breathing function in patients with acute phase required miastenia gravis.
Muscle weakness usually happens in ekstraokular asymmetrical. Weakness often affect more than one muscle ekstraokular, and not just limited to the muscles that diinervasi by a cranial nerve. This is a very important sign for diagnosing miastenia gravis. The weakness in the lateral and medial rectus muskulus will cause pseudointernuclear ophthalmoplegia, marked by adduction of one eye on the limited ability of the eyes accompanied nistagmus kidnapping.
To miastenia gravis diagnosis, examination may be conducted as follows:
1. Patients were assigned to count out loud. Finally, you will hear his voice grew weaker and less bright. Patients become anartris and afonis.
2. Patients assigned to his eyes blink constantly. Ptosis will occur from time to time. After the patient became hoarse voice or see any ptosis, the patient was told to rest .. Then came that voice will be back better and ptosis was not seen again.
To confirm the diagnosis miastenia gravis, several tests can be conducted between lain3:
1. Tensilon test (edrophonium chloride)
To test tensilon, 2 tensilon mg injected intravenously, if there is a reaction to it again as many as 8 mg was injected intravenously tensilon. Immediately after injection tensilon It should be noted that the muscle is weak, such as eyelid ptosis shows. If that's true weakness is caused by miastenia gravis, ptosis will soon disappear. In uiji weak eyelid should be considered very carefully, because the effectiveness of very short tensilon.
2. Test Prostigmin (neostigmin)
In this test injected 3 cc or 1.5 mg administered intramuscularly merhylsulfat prostigmin (if necessary, were also given atropine ¼ or ½ mg). If that's true weakness is caused by miastenia gravis symptoms such as ptosis, strabismus or other weaknesses will not soon disappear.
3. Kina test
3 given quinine tablets 200 mg. 3 hours and then given another three tablets (each 200 mg per tablet). If that's true weakness is caused by miastenia gravis, later symptoms such as ptosis, strabismus and other people will gain weight. For this test, should be prepared prostigmin injection wells, in order miastenik symptoms do not gain weight.
vis is an autoimmune disorder characterized by abnormal and progressive weakness of skeletal muscle that is used constantly and is accompanied by fatigue during recess beraktivitas.Bila patients, so there is no muscle power will soon recover. This disease occurs due to disruption or synaptic transmission at the neuromuscular junction.
Epidemiology
Miastenia gravis is a rare disease, and can occur at any age. This disease is usually more often seen at the age of 20-50 years. Women more often than men suffer from this disease. Ratio of women and men who suffer miastenia gravis is 6: 4. In women, this disease appears early in life, which is about 28 years, whereas in men, the disease often occurs at the age of 42 years.
ANATOMY, PHYSIOLOGICAL, and biochemical neuromuscular junction
a. Anatomy of the neuromuscular junction
Before an understanding of miastenia gravis, knowledge of anatomy and normal function of the neuromuscular junction is very important. Every normal nerve fibers branched several times and stimulated three to several hundred skeletal muscle fibers. nerve endings to create a connection called the neuromuscular junction or the neuromuscular junction. Part of motor nerve terminals eventually called the ball wide on the terminal, which lies in between the cracks found along nerve fibers. Presinaptik membrane (membrane of the nerve), post-synaptic membrane (membrane of the muscle), and the synapse is a gap to form part of the neuromuscular junction.
b. Neuromuscular Physiology and Bi
ochemistry
Synapse is the gap between the membrane and presinaptik post synaptic membrane. Ranged from 20-30 nanometers wide and filled by a basal lamina, which is a thin layer of reticular fibers as the foam that can be passed by the extracellular fluid by diffusion. Presinaptik terminals containing acetylcholine-containing vesicles in it (ACH). Acetylcholine is synthesized in the cytoplasm terminal, but quickly absorbed into the small number of synaptic vesicles, which are usually located at the terminal end plate motor (the motor end plate). When a nerve impulse arrives at the neuromuscular junction, approximately 125 bags of acetylcholine release from synaptic terminals into the crack. When the action potential spreads throughout the terminal, there will be diffusion of calcium ions into the interior of the terminal. Calcium ions then have the effect of acetylcholine vesicles is expected to attract. Some will be incorporated into the membrane vesicles and released into the nerve asetilkolinnya synaptic gap. Release of acetylcholine diffuses throughout the synapse and bind to the acetylcholine receptors (AChRs) in the post synaptic membrane. With a biochemist at the neuromuscular junction whole process takes place in six stages are considered, namely:
1. Acetyl choline synthesis occurs at the nerve terminal cytosolic enzyme choline acetyltransferase using catalyzed reaction follows: Acetyl-CoA + choline + CoA à Acetylcholine
2. Acetylcholine then inserted into a small vesicle-membrane bound particles called sinap and stored in vesicles.
3. The release of acetylcholine from synaptic vesicles to the gap represents the next stage. This occurs through eksositosis involving vesicle fusion with the membrane presinaptik. In the resting state quanta, single (about 10,000 transmitter molecules that may be appropriate to the content of synaptic vesicles) will be released spontaneously, resulting in a small miniature endplate potential. If the end of the depolarization caused by nerve experienced transmission of nerve impulses, the process will open the channels Ca2 + sensitive to voltage, which allows the entry of Ca2 + from the space into synaptic nerve terminals. This Ca2 + ions play an important role in asitilkolin eksositosis release (the contents of about 125 vesicles) into the cavity of the synapse.
4. Acetylcholine is released will spread rapidly in the synaptic gap to receptor within the folds of the links (junctional folds), are an important part containing the motor end plate acetylcholine receptor (AChR) with high density and very dense with nerve terminal. If the two molecules bound to the acetylcholine receptor, the receptor will change shape by opening the channels of the receptor that allows the flow of cations across the membrane. The entry of Na + ions will cause depolarization of muscle membrane, forming an end plate potential. This situation will then lead to muscle membrane depolarization and action potential occurred near transmitted along nerve fibers causing muscle contraction.
5. If the channel is closed, acetylcholine will rot and hydrolyzed by the enzyme acetylcholinesterase which catalyzes the following reaction: Acetylcholine + H ¬ ¬ à Acetate + 2o Kolin.Enzim important to have large quantities in the cavity of synaptic basal lamina
6. Recycling choline into nerve terminals via an active transport mechanism in which the protein can be reused for the synthesis of acetylcholine.
Each of acetylcholine receptors are large protein complexes with channels that will open soon after the compliance of acetylcholine. This complex consists of five protein subunits, yatiu 2 alpha protein, and one each protein, beta, delta and gamma. Acetylcholine compliance allows the sodium can move easily across the channel, so that will happen partial depolarization of the post-synaptic membranes. This event will cause a change in local potential at the muscle fiber membrane called excitatory postsynaptic potential (the potential end of the plate). When opening the door of sodium is sufficient, there will be action potentials in the muscle membrane which in turn causes muscle contraction.
Some properties of acetylcholine receptors at the neuromuscular junction are as follows:
• Represents nikotinik receptor (nicotine receptor agonists are)
• It is a membrane glycoprotein with a molecular weight of about 275 kDa.
• Contains five subunits, consist of?
• Only a subunit? acetylcholine binds with high affinity.
• Two acetylcholine molecules must bind to open ion channels, which allow the flow of either Na + or K +.
• Can the snake-binding Bungarotoksin? Subunits closely, and can be used to label as a receptor or ligand berafinitas to fix it.
• autoantibody to the receptor, including the cause of miastenia graphics.
Pathophysiology
Immunogenic mechanisms play a very important role in the pathophysiology miastenia gravis. Clinical observations that support this, including autoimmune disorders associated with the incidence of patients who suffer miastenia gravis, such as autoimmune thyroiditis, systemic lupus erythematosus, rheumatoid arthritis, and others.
Starting in 1960, has demonstrated how autoantibodi miastenia gravis patients in the serum directly to constituents in the muscle. This is what plays an important role in weakening the muscles of patients with miatenia gravis. No doubt, that nikotinik acetylcholine receptor antibody on the main causes of muscle weakness in patients with miastenia gravis. Autoantibodi against acetylcholine receptor (anti-AChRs) has been detected in the serum of 90% of patients suffering from acquired gravis gravis general.
Appropriate mechanisms of loss of tolerance to the acetylcholine receptor imunologic miastenia gravis patients are not fully understood. Miastenia gravis can be said as a "disease associated with B cells", in which antibodies are the product of B cells in fact against the acetylcholine receptor. The role of T cells in the pathogenesis miastenia gravis began increasingly prominent. Thymus is the central organ of the immune abnormalities associated with T cell hyperplasia of the thymus as the thymus or thymoma, usually appears earlier in patients with symptoms miastenik. In miastenia gravis patients, IgG antibodies consist of a variety of different subklas, where one antibody directly against the main immunogenic region on the alpha subunit. Alpha subunit is also the acetylcholine binding site. Association of acetylcholine receptor antibodies on acetylcholine receptor would lead to obstruction of neuromuscular transmission in several ways, including: cross-acetylcholine receptor anti-acetylcholine receptor antibodies and reducing the number of acetylcholine receptors at the neuromuscular junction by way of destroying the connection of the bonds at post synaptic membrane, thereby reducing the surface area that can be used for the insertion of newly synthesized acetylcholine receptors.
CLINICAL SYMPTOMS
Miastenia gravis characterized by fluctuating skeletal muscle weakness and this weakness will increase every time they move. Patients will feel very weak muscles in the day and this weakness will be reduced if the rest of the patient. Miastenia gravis clinical symptoms include:
a. Weakness in the muscles or ptosis ekstraokular
Ptosis, which is one symptom of okulomotorius nerve paralysis, the main complaint seing miastenia gravis patients. Although miastenia gravis on unclear palpebra Levator muscle paralysis, but sometimes the eye muscles are still moving normally. But in advanced stages of ocular muscle paralysis on both sides will complete ptosis miastenia gravis. bulbar muscle weakness are also common, followed by weakness in flexion and extension of the head. Patients with muscle weakness gets worse the longer it will. weakness will spread from the ocular muscles, facial muscles, neck muscles, the muscles of extremities. From time to time can also arise from the masseter muscle weakness so difficult for the patient's mouth shut. But they can also arise from the weakness of the muscles of the pharynx, tongue, Lissoclinum pallatum, and larynx so that the resulting difficulty swallowing and speaking. Paresis of Lissoclinum pallatum will cause nasal voice. Also if the patient drink water, water can get out of his nose.
CLASSIFICATION MIASTENIA Gravis
According to the Myasthenia Gravis Foundation of America (MGFA), berikut7 miastenia gravis can be classified as:
a. First class
The existence of the weakness of ocular muscles, weakness at the time of closing the eyes, and other muscles of normal strength.
b. Class II
There are more severe ocular muscle weakness, and mild muscle weakness in muscles other than ocular.
c. Class IIa
Affect axial muscles, limbs, or both. There are also mild weakness of oropharyngeal muscles.
d. Class IIb
Affecting oropharyngeal muscles, respiratory muscles or both. Weakness in leg muscles and axial muscles are lighter than grade IIA.
e. Class III
There are serious weaknesses in the ocular muscles. While other muscles in addition to moderate muscle weakness experienced eye.
f. Class IIIA
Affecting the leg muscles, axial muscles, or both, is very dominant. There was mild weakness of oropharyngeal muscles.
g. Class IIIB
Affect oropharyngeal muscles, respiratory muscles, or both, is very dominant. There is weakness of leg muscles, axial muscles, or both, in light level.
h. Class IV
Other than experience severe muscle weakness in the degree of ocular muscles, whereas the ocular muscle weakness experienced in various degrees.
i. Class IVA
With primarily affects the muscles or limbs and axial muscles. oropharyngeal muscle weakness is experienced in mild degrees.
j. Class IVb
Affecting the oropharyngeal muscles, respiratory muscles or both, the main thing. There is also a weakness in the muscles of limbs, axial muscles, or both with a mild degree. Patients using a feeding tube without intubation performed.
k. Class V
Terintubasi patients, with or without mechanical ventilation.
Usually symptoms closet gravis ptosis and strabismus miastenia will not be visible in the morning. At night or during hot weather, symptoms will appear more clearly. On examination, the muscle appeared somewhat decreased.
Miastenia gravis can also be grouped with a more simple way as below ini3:
a. Miastenia gravis with mild ptosis or diplopia.
b. Miastenia gravis by ptosis, diplopi, and weakness of the muscles for chewing, swallowing and speaking. tubuhpun members can participate Muscles become weak. Breathing is not affected.
c. Gravis Miastenia happens fast with muscle weakness okulobulbar. Breathing is not affected. Patients can die.
DIAGNOSIS MIASTENIA Gravis
a. Diagnosis Enforcement Miastenia Gravis
With a thorough physical examination should be performed to diagnose miastenia gravis. muscle weakness can occur in different degrees, typically in the proximal part of the body and symmetrical on both left and right leg. tendon reflexes are usually still within normal limits.
Miastenia gravis is usually always accompanied by weakness of facial muscles. Bilateral facial muscle weakness will cause the face like a mask with ptosis and horizontal smile.
bulbar muscle weakness are also common in patients with miastenia gravis. On physical examination, there was muscle weakness of the palate, which causes sufferers sounds like being in the nose (nasal twang to the voice) and regurgitation of food, especially the character of liquid into the patient's nose. In addition, miastenia gravis patients will have difficulty in chewing and swallowing food, so it can happen menyebabbkan fluid aspiration when drinking cough and choke. Weakness in the muscles of the jaw causes miastenia gravis patients difficult to close the mouth, chin so that the patient should be kept continuous with his hands. neck muscles are also experiencing weakness, so that an interruption occurs during flexion and extension of the neck.
Limb muscles from certain experiences more often than the weakness of the muscles of the body of another member, whereby the muscles of your upper body more frequently experience muscle weakness compared with the lower limb. Deltoid muscle function and extension at the wrist and fingers often experience weakness. Triceps muscles more commonly affected than the biceps. At the bottom of the foot, weakness often occur when doing hip flexion, and dorsiflexion of the toes as compared with the toes do plantarfleksi.
respiratory muscle weakness can result from acute respiratory failure, which is a state of emergency and quick action is required intubation. Intercostal and diaphragm muscle weakness can cause retention of carbon dioxide will cause hypoventilation. pharyngeal muscle weakness may cause airway collapse, strict controls breathing function in patients with acute phase required miastenia gravis.
Muscle weakness usually happens in ekstraokular asymmetrical. Weakness often affect more than one muscle ekstraokular, and not just limited to the muscles that diinervasi by a cranial nerve. This is a very important sign for diagnosing miastenia gravis. The weakness in the lateral and medial rectus muskulus will cause pseudointernuclear ophthalmoplegia, marked by adduction of one eye on the limited ability of the eyes accompanied nistagmus kidnapping.
To miastenia gravis diagnosis, examination may be conducted as follows:
1. Patients were assigned to count out loud. Finally, you will hear his voice grew weaker and less bright. Patients become anartris and afonis.
2. Patients assigned to his eyes blink constantly. Ptosis will occur from time to time. After the patient became hoarse voice or see any ptosis, the patient was told to rest .. Then came that voice will be back better and ptosis was not seen again.
To confirm the diagnosis miastenia gravis, several tests can be conducted between lain3:
1. Tensilon test (edrophonium chloride)
To test tensilon, 2 tensilon mg injected intravenously, if there is a reaction to it again as many as 8 mg was injected intravenously tensilon. Immediately after injection tensilon It should be noted that the muscle is weak, such as eyelid ptosis shows. If that's true weakness is caused by miastenia gravis, ptosis will soon disappear. In uiji weak eyelid should be considered very carefully, because the effectiveness of very short tensilon.
2. Test Prostigmin (neostigmin)
In this test injected 3 cc or 1.5 mg administered intramuscularly merhylsulfat prostigmin (if necessary, were also given atropine ¼ or ½ mg). If that's true weakness is caused by miastenia gravis symptoms such as ptosis, strabismus or other weaknesses will not soon disappear.
3. Kina test
3 given quinine tablets 200 mg. 3 hours and then given another three tablets (each 200 mg per tablet). If that's true weakness is caused by miastenia gravis, later symptoms such as ptosis, strabismus and other people will gain weight. For this test, should be prepared prostigmin injection wells, in order miastenik symptoms do not gain weight.
Control High Cholesterol Levels
Cholesterol forms every cell in the body. When cholesterol levels, the appropriate role of his life in many body functions. When cholesterol is at a good level it works to build and repair cells, produce hormones like estrogen and testosterone, and produces bile acids are proven to assist in the digestion of fat.
Cholesterol, triglycerides, Apo B protein in LDL, are words dreaded by humans of the modern age. This new century is expected to become the century of medical miracles, green tea, low-sound looks very promising as several researches have shown. This could be a decade of green tea and cholesterol.
Causes of High Cholesterol:
Hypercholesterolemia, which literally means high blood cholesterol, is the presence of high levels of cholesterol in the blood. Continued study of treatment with supplements such as policosanol, and policosanol side effects, and effects of diet and cholesterol, stress and cholesterol, and alcohol and cholesterol, has helped millions of patients world who face this medical condition.
Symptoms of High Blood Cholesterol:
• General fatigue
• Excess sweating and feeling of anxiety
• Pain and heaviness in the chest area
• breath
Cholesterol is produced in the liver. Food from animals contain cholesterol as well - perhaps because the animal has a heart as well. Some vegetables also contain cholesterol and saturated fat. Cholesterol is a fatty substance such bonds to the protein before the start of travel through the bloodstream. When bonds to the protein, the result is a cholesterol-lipoprotein
• Lowers blood triglycerides - high triglycerides, known as risk factors for cardiovascular disease.
• Helps reduce the likelihood of blood clots - fish oil benefits including prevention of blood platelets from sticking together and forming blood clots.
• Lowers high blood pressure light - fish oil helps lower blood pressure at the time was because of high cholesterol and hardening of the arteries.
• Reduces inflammation from rheumatoid arthritis, psoriasis and gout - fish oil health benefits come from DHA and EPA that reduce the amount of inflammation-causing substances.
• Lowers the risk of Alzheimer's disease - studies have found that fish oil seems to help protect the nervous system.
• Reduce depression - lack of DHA has been linked with a higher incidence rate of depression.
All forms of cholesterol drugs work the same way. In our blood, we have a mixture of lipids, including LDL, HDL and triglycerides. Is actually a form of LDL cholesterol that we need to reduce. HDL cholesterol, on the other hand, can be classified as a form of benefit from cholesterol that the body needs to function properly. Works all the cholesterol drugs to reduce levels of LDL and triglycerides in the blood and, in some cases, raise HDL levels.
Cholesterol, triglycerides, Apo B protein in LDL, are words dreaded by humans of the modern age. This new century is expected to become the century of medical miracles, green tea, low-sound looks very promising as several researches have shown. This could be a decade of green tea and cholesterol.
Causes of High Cholesterol:
Hypercholesterolemia, which literally means high blood cholesterol, is the presence of high levels of cholesterol in the blood. Continued study of treatment with supplements such as policosanol, and policosanol side effects, and effects of diet and cholesterol, stress and cholesterol, and alcohol and cholesterol, has helped millions of patients world who face this medical condition.
Symptoms of High Blood Cholesterol:
• General fatigue
• Excess sweating and feeling of anxiety
• Pain and heaviness in the chest area
• breath
Cholesterol is produced in the liver. Food from animals contain cholesterol as well - perhaps because the animal has a heart as well. Some vegetables also contain cholesterol and saturated fat. Cholesterol is a fatty substance such bonds to the protein before the start of travel through the bloodstream. When bonds to the protein, the result is a cholesterol-lipoprotein
• Lowers blood triglycerides - high triglycerides, known as risk factors for cardiovascular disease.
• Helps reduce the likelihood of blood clots - fish oil benefits including prevention of blood platelets from sticking together and forming blood clots.
• Lowers high blood pressure light - fish oil helps lower blood pressure at the time was because of high cholesterol and hardening of the arteries.
• Reduces inflammation from rheumatoid arthritis, psoriasis and gout - fish oil health benefits come from DHA and EPA that reduce the amount of inflammation-causing substances.
• Lowers the risk of Alzheimer's disease - studies have found that fish oil seems to help protect the nervous system.
• Reduce depression - lack of DHA has been linked with a higher incidence rate of depression.
All forms of cholesterol drugs work the same way. In our blood, we have a mixture of lipids, including LDL, HDL and triglycerides. Is actually a form of LDL cholesterol that we need to reduce. HDL cholesterol, on the other hand, can be classified as a form of benefit from cholesterol that the body needs to function properly. Works all the cholesterol drugs to reduce levels of LDL and triglycerides in the blood and, in some cases, raise HDL levels.
Hirschsprung disease
There are several notions of Mega Colon, but in essence the same that is a disease caused by a mechanical obstruction caused by inadequate motility of the intestines so there is no spontaneous bowel evacuation and not capable spinkter rectum relaxes.
Hirschsprung's disease or Mega Colon is the absence of cell - ganglion cells in the rectum or part rektosigmoid Colon. And this situation causes instability abnormality or absence of peristalsis and absence of spontaneous bowel evacuation (Betz, Cecily & Sowden: 2000). Hirschsprung disease or congenital abnormality Mega Colon is the cause of intestinal disorders common passage in neonates, and mostly occur in infants with birth weight aterm 3 Kg, more men - men than women.
Hirschsprung's disease or Mega Colon is the absence of cell - ganglion cells in the rectum or part rektosigmoid Colon. And this situation causes instability abnormality or absence of peristalsis and absence of spontaneous bowel evacuation (Betz, Cecily & Sowden: 2000). Hirschsprung disease or congenital abnormality Mega Colon is the cause of intestinal disorders common passage in neonates, and mostly occur in infants with birth weight aterm 3 Kg, more men - men than women.
Liver Fungtion
liver is the center of metabolism throughout the body, is the source of the body's energy use by 20% and 20-25% of blood oxygen. There are several liver functions, namely:
Carbohydrate metabolism of liver function
Formation, and changes of KH solution, fats and proteins related to each other a similar .liver change the pentoses and hexoses are absorbed from the intestine into glycogen, this mechanism is called glikogenesis. And glycogen in the liver and then dumped in the liver glycogen to glucose would solve. Solving process of glucose called glycogen mjd glikogenelisis. because these processes, the liver is the main source of glucose in the body convert glucose through subsequent liver shunt monophosphat hexoses and pentoses formed. Pentose formation has several purposes: To generate energy, biosynthesis of nucleotides, nucleic acid and ATP, and forming / 3-carbon compound biosynthesis (3C) is piruvic acid (pyruvic acid required in the Krebs cycle).
Liver function as lipid metabolism
liver not only shape / synthesize fat but once entered katabolisis fatty acids fatty acids broken down into several components:
1. 4 carbon - Ketone Bodies
2. two carbon - ACTIVE acetate (broken down into fatty acids and glycerol)
3.binding cholesterol
4.binding and phospholipid solution
Liver is the main formation, synthesis, esterification and excretion of cholesterol. Where is the standard examination of serum cholesterol to lipid metabolism
Liver function as protein metabolism
Liver to synthesize many kinds of proteins from amino acids. deamination process, the liver also synthesizes glucose from fatty acids and acid transamination amino.Dengan process, the liver produces amino acids from non-nitrogenous substances. Liver is the only organ who form the plasma albumin and ∂ - globulin and the main organ for the production urea.Urea an end product of protein metabolism. ∂ - globulin in addition formed in the liver, was also formed in the spleen and bone marrow β - globulin was only formed in in hati.albumin containing 584 ± 66 000 amino acids with molecular
Liver function in relation to blood clotting
Liver is an important organ for the synthesis of proteins related to blood coagulation, for example: forming fibrinogen, protrombin, factor V, VII, IX, X. Taxable foreign body piercing the blood vessels - which is a factor ekstrinsi action, if any relationship with heart valve - the action is intrinsik.Fibrin factors have a strong let isomers pembekuannya and supplemented with the factor XIII, while the Vit K is required for the formation protrombin and several coagulation factors.
The function of the liver as vitamin metabolism
All the vitamins are stored in the liver, especially vitamins A, D, E, K
Liver function as detoksikation
The liver is the center of the body detoksikasi, detoksikasi process occurs in the process of oxidation, reduction, methylation, esterification and conjugation to a variety of materials such as toxic substances, drug overdose.
Liver function as phagocytosis and immunity
Tues Kupfer is an essential filter bacteria, pigments and other materials through the process of phagocytosis. Besides that Kupfer cells also co-produced ∂ - immune globulin as a mechanism livers.
Hemodynamic function
liver received a level ± 25% of cardiac output, blood flow to normal liver ± 1500 cc / min or 1000 to 1800 cc / min. Blood flowing in a.hepatica ± 25% and in 75% of all v.porta blood flow to the heart. Blood flow to the liver is influenced by mechanical factors, the influence of neural and hormonal, flow is changed rapidly at the time of exercise, sun, shock.Hepar an important organ for maintaining blood flow.
liver
The liver is the largest gland in the human body. Liver in humans is located on the top of the cavum abdominis, below the diaphragm, on both sides of the quadrant, which are mostly found on the right. Weighing 1200 - 1600 grams. The upper surface is situated below the diaphragm into contact, under the surface lies in contact over the abdominal organs. Liver were fixed in close by intra-abdominal pressure and wrapped by peritoneum except at the posterior-superior regions adjacent to the inferior v.cava and direct contact with the diaphragm. Parts that are not covered by the peritoneum is called bare area.Terdapat peritoneal reflection from the anterior abdominal wall, diaphragm and abdominal organs to the liver such as ligaments.
umami
Umami is one of the five basic taste, umami is induced solely and one of the five basic tastes, and solely due to synergistically by free glutamate and 5-mononucleotides free and synergistically with glutamate -mononucleotides
Poor 'inosine 5-monophosphate (IMP) and guanosine 5 - such as inosine 5-monophosphate (IMP) and uanosine 5 - monophosphate (GMP). monophosphate (GMP). Now, for umami sensing, Standard Chartered Bank re-present, for sensing umami, some receptors Standard and Poor 's taste receptor (T1R1/T1R3 heterodimer) and ceptors such as taste receptors (heterodimer T1R1/T1R3) and the metabotrophic glutamate receptors (mGluR1 and mGluR4) metabotrophic glutamate receptors (mGluR1 and mGluR4) are proposed in the taste buds on the tongue. proposed in the taste buds on the tongue. These umami umami this substances are widely distributed in the vegetables, Meats, widespread substances in vegetables, meat, and fishes, and ESPECIALLY concentrated in the traditional food and fish, and mainly concentrated on traditional foods Poor 'materials dried seaweed "kombu", tomato, cheese, ingredients such as dried seaweed "kombu", tomato, cheese, soy sauce, dried Mushroom and dried fishes. soy sauce, dried mushrooms and dried fish. For example, in example, in Japan, umami-taste are Considered as traditional dishes, deli-Japanese, umami-taste dishes that are considered as traditional, storecious, Relaxed foods and daily intake of free glutamate is estimates cious, relaxed and the daily food intake of free glutamate Estimated to be more than 1.6g per person. mated with more than 1.6g per person. Thus cooking using So cooking uses These "umami" food materials is the best shortcut to have de-is "umami" food is the best shortcut to a delicious dishes, leading to Enough "satisfaction". licious plate, causing enough "satisfaction".
"Eat well, be well, and live better" food is our through the "Eat a good, good, and live better" through our food final goal. The final destination. To accomplish this, We Are Studying to vigorously To achieve this, we learn to hard Clarify The Mechanisms of "eating behavior" from a variety explain the mechanism of "feeding behavior" of varieties of aspect. aspects. ESPECIALLY, We are now focusing on the physiological-Especially, we now focus on the physiologicalcal roles of free glutamate in the regulation of gastrointesti-cal role of free glutamate in the regulation of gastrointestinal functions. nal function. Recently, We proposed the presence of Gluta-Recently, we proposed the existence of GlutaFollowing mate sensing and the signaling pathway in the partner sensing and signal pathways in the following stomach. stomach. In this topic, and new We show previous findings of the topic, we display the previous and new findings dietary free glutamate in the regulation of gastrointestinal dietary free glutamate in the regulation of gastrointestinal functions and then propose Some applications of the benefits of functions and then propose several applications benefit for the clinical gastrointestinal disorders. for clinical gastrointestinal disorders.
Poor 'inosine 5-monophosphate (IMP) and guanosine 5 - such as inosine 5-monophosphate (IMP) and uanosine 5 - monophosphate (GMP). monophosphate (GMP). Now, for umami sensing, Standard Chartered Bank re-present, for sensing umami, some receptors Standard and Poor 's taste receptor (T1R1/T1R3 heterodimer) and ceptors such as taste receptors (heterodimer T1R1/T1R3) and the metabotrophic glutamate receptors (mGluR1 and mGluR4) metabotrophic glutamate receptors (mGluR1 and mGluR4) are proposed in the taste buds on the tongue. proposed in the taste buds on the tongue. These umami umami this substances are widely distributed in the vegetables, Meats, widespread substances in vegetables, meat, and fishes, and ESPECIALLY concentrated in the traditional food and fish, and mainly concentrated on traditional foods Poor 'materials dried seaweed "kombu", tomato, cheese, ingredients such as dried seaweed "kombu", tomato, cheese, soy sauce, dried Mushroom and dried fishes. soy sauce, dried mushrooms and dried fish. For example, in example, in Japan, umami-taste are Considered as traditional dishes, deli-Japanese, umami-taste dishes that are considered as traditional, storecious, Relaxed foods and daily intake of free glutamate is estimates cious, relaxed and the daily food intake of free glutamate Estimated to be more than 1.6g per person. mated with more than 1.6g per person. Thus cooking using So cooking uses These "umami" food materials is the best shortcut to have de-is "umami" food is the best shortcut to a delicious dishes, leading to Enough "satisfaction". licious plate, causing enough "satisfaction".
"Eat well, be well, and live better" food is our through the "Eat a good, good, and live better" through our food final goal. The final destination. To accomplish this, We Are Studying to vigorously To achieve this, we learn to hard Clarify The Mechanisms of "eating behavior" from a variety explain the mechanism of "feeding behavior" of varieties of aspect. aspects. ESPECIALLY, We are now focusing on the physiological-Especially, we now focus on the physiologicalcal roles of free glutamate in the regulation of gastrointesti-cal role of free glutamate in the regulation of gastrointestinal functions. nal function. Recently, We proposed the presence of Gluta-Recently, we proposed the existence of GlutaFollowing mate sensing and the signaling pathway in the partner sensing and signal pathways in the following stomach. stomach. In this topic, and new We show previous findings of the topic, we display the previous and new findings dietary free glutamate in the regulation of gastrointestinal dietary free glutamate in the regulation of gastrointestinal functions and then propose Some applications of the benefits of functions and then propose several applications benefit for the clinical gastrointestinal disorders. for clinical gastrointestinal disorders.
good for eating
When you are hungry and eat something tasty, you must feel deep satiety soon. should feel full in the near future. In this process to feel satiety, in this process to feel full, tasting with tongue alone is not Enough. tasted by the tongue alone is not enough. First, you have to First, you must "Taste" with gustatory sensors on the tongue in the oral cavity "Taste" with gustatory sensors on the tongue in the oral cavity During the masticatory process, then the Smaller pieces of during the masticatory process, then the small pieces chewed-up foods enter the stomach, and the stomach starts chewed-up food enter the stomach, and stomach start digesting the contents by sensing the volume, the hardness digesting the contents of the sensing volume, violence and the ingredients. and materials. Partially digested contents are properly digested Most of the content correctly pushed out to the intestine and the subsequent digestion, pushing out into the intestines and digestive next Poor 'proteins to amino acids, fat to fatty acids and carbohy-like proteins with amino acids, fats into fatty acids and carbohydrate to sugars, These enable nutrients to be sensed and ab-drate for sugar, allowing the nutrients it must feel and absorbed in the intestine. absorbed in the intestine. Absorption and / or sensing of Nutri-absorption and / or sensing of the Nutrients In the gastrointestinal tract Convey the nutrient to the Informa-Ent intestinal-nutrient convey informationtion via neuronal (vagus nerve) endocrine and (gastrointesti-SI through neuronal (vagus nerve) and the endocrine (gastrointestinal hormone secretion) pathways to the brain. nal secretion of hormones) path to the brain. Thus, "Sati-So," Sati-Society "Should be Considered as a kind of highly-integrated-Ety feel" should be regarded as a kind of highly-integrated feeling recognized by brain after processing the visceral Sensational-ing recognized by the brain after Sensational-depth processing tion (which metabolically modulates the blood levels of ab-SI (which modulate the metabolism of blood levels of absorbed nutrients finely within the normal range) and the sub-fine nutrients absorbed in the normal range) and subsequent nutrient sufficiency of information from the periph-sequent nutritional information from the peripheral tissues.
Vomitus in infants
Vomiting is as the release of stomach contents into the mouth by force or with strength. Nausea and vomiting are common symptoms of functional gastrointestinal disorders, both of which serve as protection against the toxins that are not accidentally swallowed. Vomiting can be an effort to remove toxins from the gastrointestinal tract such as diarrhea in the gastrointestinal tract (neurogastrenterologi). Nausea is a response that comes from the rejection response that can be caused by taste, light, or smell.
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